Anthony C. Martin DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2590 Issued in SC

Legal business name

ANTHONY C. MARTIN DMD LLC

Practice address

111 Obrian Way
Irmo, SC 29063-8776

Phone

(803) 749-6072

NPI assigned

Dec 18, 2014

Last updated

Dec 18, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony Charles Martin, DMDNPI 1326154170

Title

President

Phone

(803) 749-6072

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Charles Martin, D.M.D.

  • General Practice Dentistry
  • Irmo, SC
  • NPI 1326154170
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1841698149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "city": "BALLENTINE",
            "state": "SC",
            "postal_code": "290020195",
            "telephone_number": "803-749-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OBRIAN WAY",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290638776",
            "telephone_number": "803-749-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY C. MARTIN DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-749-6072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "2590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z2590",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Irmo, SC
• Providers in Irmo, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.